A study of the health of Irish born people in London: the relevance of social and economic factors, health beliefs and behaviour.

This thesis argues that the health of Irish people in London is influenced by factors arising in both Ireland and Britain. Using different qualitative methods, the perceptions and experiences of Irish born people in London and professionals working with the Irish community were elicited. High levels of social distress, poor health and disability were evident and related to the experience of being Irish in London. Psychosocial factors associated with low income, poor housing and living in deprived localities added to the effects of discrimination and low socio-economic position. The insidiousness and specificity of anti-Irish racism evoked persistent feelings of insecurity, impacted on identity, access to health care and influenced ways of coping.
Factors relating to earlier life in Ireland may also account for poor health. Resentment about unfairness which compelled interviewees to leave Ireland, and failure to acknowledge their remittances persisted long after the experience of culture shock and homesickness. Aspects of childhood, schooling and Irish society, abuse in institutions or by family were clearly linked to physical or mental ill-health by interviewees. Factors from both countries influenced health beliefs and behaviour. Smoking and alcohol were culturally acceptable strategies for coping with life's difficulties and although harmful, afforded dignity and control in a hostile environment. Religious or spiritual beliefs and practices, contact with Ireland and a sense of belonging in both countries were associated with better health and greater service uptake. Contrary to expectations there was considerable willingness to discuss painful, emotional issues and engage with culturally sensitive services.
The pathways by which negative experiences impact upon health are not totally clear but the data highlight the relevance of psychosocial explanations. The thesis demonstrates a relationship between being Irish in London and ill-health but reveals the relevance of childhood experiences and factors associated with Ireland in understanding the complexity of the Irish health experience.

This thesis is submitted in partial fulfilment for the award of Doctor of Philosophy.